Sleep physicians outside America’s fee-for-service model use existing technologies to diagnose bruxism, narcolepsy, and much more without in-lab polysomnography. That landscape may change dramatically when new unattended sleep study CPT codes take effect January 1, 2027. But by 2022, new type II home sleep tests were being deployed by the sleep physicians at Herz-Jesu Krankenhaus. Still, Rama’s four-year track record with only type II testing and the occasional add-on equipment (such as an end-tidal carbon dioxide monitor) demonstrates remarkable versatility. Preparing for US Landscape ChangesAs US reimbursement models evolve, the international experience provides a possible roadmap for expanded home sleep testing implementation.